Thursday, August 12, 2010

Naturopathic Doctors, NDs or Naturally Deluded?

Whenever I encounter an ND who calls or considers himself a doctor, physician, general practitioner or scientist rather than a faith or natural healer, I think of him as naturally deluded. How else can one explain how, despite all the objective, scientific evidence to the contrary, Vermont NDs include silver in their formulary? http://rosemary-jacobs.blogspot.com/2010_08_01_archive.html How else can one explain why, despite all the evidence to the contrary, they believe that the doctorate degrees their institutions award them accurately portray who they are and qualify them to practice scientific medicine?


Having been permanently disfigured by an ignorant, though not deluded, MD over fifty years ago, it scares the hell out of me to see that NDs, most of whom probably weren’t even alive then, are still wallowing in the same ignorance that he did. For me it’s very personal. http://www.webanstrich.de/rosemary/


But naturopaths’ use and promotion of silver isn’t the only reason that I think that NDs are deluded in their belief that they are qualified to work as doctors, physicians and general practitioners or that they understand scientific or evidence-based medicine as many claim in the reams of promotional material they publish. At least two MDs who have investigated the matter agree wholeheartedly.

http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/atwood.html

http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/relman3.html

Another MD who looked at their VT formulary told me that he had no idea where they got it from because it isn’t grounded in pharmacology or toxicology as they are currently understood. I know at least one layperson who shares these views and fears, a lady who corresponded with me a few years ago who calls them naturopathetics.


Yes. I know name-calling isn’t nice, but on a moral scale it is a whole lot better than believing that you practice scientific medicine when you are so ignorant of the subject that you include in your formulary a heavy metal toxin like silver which, if taken internally or in your eyes, offers no benefits whatsoever but can permanently disfigure you.


Although NDs are required to study scientific disciplines like biochemistry and pharmacology in their four year naturopathic colleges, either: they are taught alternative biochemistry and alternative pharmacology, as in the alternative to or opposite of scientific biochemistry and pharmacology; they don’t understand what they are taught; or, they simply don’t believe in science and objective evidence other than when it supports their natural healing belief-based philosophy. Their religion. Otherwise how could they include in their studies and practice the archaic belief-based medical system of Classical Homeopathy, http://www.aanmc.org/naturopathic-medicine/naturopathic-physicians-are-rigorously-trained.php, that maintains that well shaken water and sugar pills have miraculous healing properties? Scientifically speaking that is sheer and utter nonsense that doesn’t have a shred of objective evidence to substantiate it unless you think that testimonials about famous people using it, like the lady with the funny hats, count as scientific evidence.


My guess is that Her Majesty, Queen Elizabeth, uses homeopathic “remedies” because she simply hates to abandon her ancient family traditions like silly hats, a throne, a crown, a luxurious lifestyle and the little black box of homeo “remedies” said to accompany her on her travels, which probably contains the exact same “remedies” that her ancestors took with them before the advent of scientific medicine as they traveled about by horse-drawn coaches. And again, my assessment of the scientific merits of homeopathy is shared by the vast majority of scientists and medical doctors.

http://www.telegraph.co.uk/health/healthnews/7910948/Homeopathy-will-not-be-banned-by-NHS-despite-critical-report.html

http://www.telegraph.co.uk/health/swine-flu/5956106/Homeopath-to-the-Queen-risking-patient-health-by-selling-swine-flu-remedy.html


(Please don’t make the erroneous assumption that all homeo “remedies” are benign, harmless or devoid of active ingredients because they are not. Like all unscientific systems of medicine, homeopathy and its “remedies” aren’t well regulated or standardized and the philosophies of belief-based medical systems can mutate quickly. People have been injured by products labeled “homeopathic” such as the “cold remedy” which really did contain zinc that caused anosmia, loss of smell. See p. 26:

http://www.fda.gov/downloads/Drugs/DrugSafety/DrugSafetyNewsletter/UCM192395.pdf

Also homeopathy is highly individualized and not every homeopath follows the principles of Classical Homeopathy.)


NDs also study “botanical medicine” which for many certainly seems to mean herbalism, http://www.brattleboronaturopathic.com/mary.page.html, a healing system built on the belief that many plants have medicinal properties which our ancestors discovered over the centuries by trial and error. Herbalists, unlike scientists, believe that those properties are contained in the entire plant or an entire part of a plant like the leaf or flower and make their remedies, often tinctures, using them as the raw ingredients. They think that all the ingredients in the plant work together in “synergy”, and unlike scientists, they believe that there is no need to challenge their beliefs regarding safety and efficacy by conducting controlled scientific studies to determine if the objective evidence supports their opinions.


While many plants do have medicinal properties as well as toxic properties, plants are kind of like soup, full of many different ingredients or chemicals which can vary widely depending on many things.

http://rosemaryjacobs.com/rose7.html

http://rosemaryjacobs.com/rose8.html

http://rosemaryjacobs.com/rose9.html

That is why pharmacognosists, who are scientists specializing in pharmacy, work to identify and isolate active ingredients found in natural products, not just plants. When they succeed, they extract those chemicals and use them as drugs or synthesize them in labs, producing medicines that are standardized for purity and potency, things very important to scientists and MDs who are fanatical about making sure that the medicines they use consistently provide the correct dose and who are also fanatically about only using drugs that have been adequately and objectively studied before they use them on patients to make sure that they offer benefits, the amount that offers those benefits, the amount that is toxic to the average person, the side effects they produce, and the interactions they have with other drugs, food and now supplements.


Since “dietary supplements”, many of which are herbs, have become so popular, scientists have started to study some of them too, but as yet they haven’t come up with any scientific evidence that would make me take a “medicinal herb” or “botanical remedy”.

http://hcd2.bupa.co.uk/fact_sheets/html/herbal_medicine.html


NDs also study and use Chinese medicine, another medical system not based on science that uses "remedies" that are often harmful. http://rosemaryjacobs.com/rose19.html


If it wasn’t all so very dangerous, it would be funny - grownups dressing up and playing doctor like children do and a former president of a naturopathic college alleged to be “one of the world's leading authorities on science-based natural/integrative medicine” http://www.webmd.com/joe-pizzorno-jr-nd claiming that the cure for the common cold has been found.


Joseph Pizzorno, who was the president of Bastyr naturopathic school at the time, was quoted as saying on p. 114 of the 1998 April issue of Good Housekeeping magazine that, “There really is a cure for the common cold, and it’s echinacea. I take it when I feel a cold coming on, and I virtually never get sick.” Yea. Sure Joe. Scientific studies didn’t support your claim then and they don’t support it now, twelve years later. Look at what NCCAM, National Center for Complementary & Alternative Medicine says under the heading “What the Science Says". "Study results are mixed on whether echinacea can prevent or effectively treat upper respiratory tract infections such as the common cold.” http://nccam.nih.gov/health/echinacea/ataglance.htm Scientifically speaking that means the evidence isn’t in yet, Joe. Not that we’ve found The Cure even if you take it when you feel a cold coming on and don't get sick.


But wait that isn’t all. NCCAM also states, “Side Effects and Cautions: When taken by mouth, echinacea usually does not cause side effects. However, some people experience allergic reactions, including rashes, increased asthma, and anaphylaxis (a life-threatening allergic reaction). In clinical trials, gastrointestinal side effects were most common.”


Anaphylaxis! Wow. That kills you very quickly unless you have some epinephrine on hand to inject immediately. If you have ever heard of someone allergic to bees or peanuts who died suddenly after being exposed to them, they died of anaphylactic shock. That’s a hefty price to pay to cure a cold or worse yet hoping to cure a cold. Of course, it is my guess that there are very few people who would have such a serious allergic reaction to echinacea, but how many would want to risk dying over a cold? My guess is that most of those practicing scientific medicine would think that the hoped for benefit does not outweigh the risk just the way that they think that the lack of benefits derived from ingesting silver do not outweigh the risk of being permanently discolored by it and that it is a waste of money to use any product as a drug, even one known to be safe, unless there are many solid, objective, studies, the results of which have been consistently reproduced, showing that it offers benefits outweighing the risks its use entails. But that line of thought is alien to those practicing belief-based systems of medicine. But then they do not choose their drugs on the basis of objective, scientific evidence showing benefits and risks. They choose them based on their philosophies of healing.


11 comments:

  1. I did not enjoy this

    ReplyDelete
  2. Anonymous, perhaps then you have an inkling of the displeasure, lack of enjoyment, I get from knowing that a profession that totally lacks the knowledge and training to practice medicine is being given the legal right to do so and to call themselves doctors. Maybe someday you will get an inkling of the terror that awakens in me.

    ReplyDelete
  3. "Very few people who would have such a serious allergic reaction to echinacea, but how many would want to risk dying over a cold?" It's true that some people may have allergies to echinacea, but some people may have allergies to "traditional" cold medicine too. You're right though - it's all about benefits vs. risks.

    Also, I thought it was interesting that you were "permanently disfigured by an ignorant, though not deluded, MD", and yet you defend traditional medicine so staunchly while attacking naturopathic medicine so passionately. I would be interested in hearing your reasoning.

    Thank you for your time.

    Sincerely,
    Someone who supports both traditional and naturopathic medicine

    ReplyDelete
  4. I do not defend "traditional medicine". I believe in evidence-based medicine or scientific medicine. That is not something that every MD practices but it is what has traditionally been taught in medical schools and never taught in naturopathic schools.

    The medical sciences taught in medical schools like pharmacology, toxicology, oncology, immunology, etc. are scientific disciplines with conclusions based on objective evidence. NDs take courses with similar titles, but if the content is actually the same, and I doubt that it is, they are never taught and never figure out for themselves that the main point of these sciences is that they are all supported by large bodies of high quality studies which consistently give the same results, something which is not the case with most of the remedies and therapies used in naturopathic medicine.

    I know this is all complicated. I am working on blogs now to try to explain these concepts. I hope you follow them. I appreciate your feedback. Thanks.

    ReplyDelete
  5. Elaine, the NDs of today, the ones with degrees from "accredited 4-year naturopathic schools" insist that the remedies and therapies that they routinely use are supported by objective evidence of safety and efficacy even when presented with overwhelming evidence (silver is one example) that that isn't true. That is why I think they are deluded.

    As far as I know my MD didn't continue to insist that claims were true when faced with evidence that they were not. He simply believed drug manufacturer's claims without independently verifying them in an era when drug companies were as unregulated as the supplement companies of today. He was naive and negligent but not deluded.

    ReplyDelete
  6. Thank you for your replies! I laud you for your support of evidence-based medicine, and for fighting for what you believe in.

    To your first reply, I think that naturopathic schools may have evolved a bit from when you took the courses (if you did). The NDs and MDs that I know have discussed between themselves before and they concluded that the two programs share very similar course content and approaches to science, at least for the first two years of study.

    As for your second reply, I have this to say. Lack of evidence that something does work, isn't evidence that something doesn't work. True, it's not yet known how a lot of naturopathic remedies and therapies work (or don't work), but it's also not yet known how many conventional drugs and therepies work. Again, it really comes back to the risks vs benefits. And in the end, I think that it's partly - if not wholly - up to the patient/consumer to decide on the best treatment for them.

    ReplyDelete
  7. Elaine, thank you for talking to me. I believe in communication and appreciate it very much. I am not an ND. Neither am I an MD or a scientist of any kind. I am a 70 yr. old woman, a retired Montessori teacher, who was disfigured by a silver drug prescribed by a naive, incompetent but truly caring MD over 50 years ago. My story is here:
    http://rosemaryjacobs.com/rose3.html

    My doctor was one of the very last MDs to use silver internally. The others read their medical journals and knew better. They saw the articles warning about the fraudulent ads for silver from drug companies in an era when drug companies were as free to do whatever they wanted as the supplement companies of today are. This taught me a powerful lesson. If it is important and I’m not comatose, I look at the evidence.

    In 2010 I learned that licensed NDs with degrees from “4-year accredited naturopathic schools” in my state, Vermont, have a state sanctioned formulary that includes silver even for IV use which is a violation of federal drug law. My efforts to warn the NDs were ignored. Most of my blog covers that. But look at the summary here:
    http://rosemaryjacobs.com/naturopaths.html
    Be sure to scroll to the bottom to see my friend Arline who came to the conference with me and whom the NDs also ignored.

    No matter what NDs or MDs claim a profession that uses dangerous snake oil that offers no benefits whatsoever when consumed and ignores those who present them the evidence of that is not practicing evidence-based medicine. They are practicing belief-based medicine.

    NDs, unlike MDs who don't consider themselves alts, routinely use products that have never been evaluated scientifically. That is the exact opposite of practicing EBM and extremely dangerous. It terrifies me.

    ReplyDelete
  8. I realize that lack of evidence doesn’t demonstrate that something doesn’t work, but without a large body of objective evidence that consistently gives the same results, there is no way to know that something does work and until a substance is adequately studied there is no way to know the risks involved in using it. Without knowing the risks and benefits of a drug or remedy, one can’t make an informed decision about it. This is a concept accepted and taught in med school but not in naturopathic school. If it were, NDs would not routinely use untested drugs and therapies.
    Also, there is a ton of evidence showing that taking silver internally doesn’t provide any benefits whatsoever and a ton of evidence showing that it can cause argyria, gray skin. (Please check my links or ask me for them if they are inactive.) Yet in spite of this NDs use, promote and sell silver.
    Those who believe in and practice EBM often use things when there is good evidence that they work even though they don’t know the mechanism of action by which they work, but before they use them routinely, they study them to determine that they work and that they are safe. They also study them to determent the correct and toxic doses.
    NDs on the other hand routinely use substances before doing any such studies. As I’ve repeated so many times, that terrifies me. I fear there could be something used routinely by many that is totally useless as lethal as cigarettes but that by the time it is discovered it will be too late to save many from premature deaths. Here is a very good example: http://rosemary-jacobs.blogspot.com/2012/05/deadly-folk-medicine.html

    ReplyDelete
  9. I found your story very interesting (http://rosemaryjacobs.com/rose3.html), so thank you for sharing it.

    You're absolutely right about evidence-based medicine. The only part where I have a differing opinion is that I think that not all NDs are necessarily non-EBM based. It would depend on the practitioner, no matter what degree they obtain. I myself am entering medical school (I've applied to both conventional and naturopathic schools) and believe in using what has been found to work, whether it's been *classed* as mainstream or alternative medicine. Whether I end up as an MD or an ND, I would never give a patient any therapy if I was personally unsure about the risks and benefits. After all, the first and most important thing you learn when becoming a doctor is "firstly, do no harm".

    I'm just trying to say that not all NDs are "wrong" or "bad". It depends on the person. I do understand your point of view though.

    Thank you for the thought-provoking discussion. Take care.

    ReplyDelete
  10. Elaine, I do not know how anyone who believes in evidence-based medicine can go to a "medical school" which teaches people to routinely use homeopathy and untested supplements which aren't even standardized for purity and potency or think that a profession that teaches those modalities as therapeutics to be routinely used could be considered a profession that practiced EBM.

    I also think that a profession which includes silver, for IV use no less in violation of federal law, in its state sanctioned formulary can claim to practice, understand or value EBM. The inclusion of silver by 241 licensed NDs including their state reps shows me that the profession, not individuals, but the profession, knows nothing about the basics of pharmacology or toxicology or even how to find evidence by searching PubMed like an informed consumer would.

    Even worse than that though as far as I am concerned is the manner in which the VT NDs have ignored me and my friend Arline when we told them of our concerns about silver in their formulary. That to me indicates that they practice a belief-based system of medicine, not an evidence-based one and that the profession itself is dangerous indeed because it doesn't recognize that.

    Thanks for your comments.

    ReplyDelete
  11. You have discussed an interesting topic that everybody should know. Very well explained with examples. i have found a similar websitehomeopathic medicine treatment visit the site to know more about herbsonlineshop

    ReplyDelete